Nutrition Research and Practice 2016;10(6):590-596 ⓒ2016 The Korean Nutrition Society and the Korean Society of Community Nutrition http://e-nrp.org The amelioration of plasma lipids by Korean traditional confectionery in middle-aged women: A cross-over study with western cookie Sun Hee Hong1, Mijeong Kim1, Minji Woo1, Jeong Sook Noh2, JaeHwan Lee3, Lana Chung4 and Yeong Ok Song1§ 1Department of Food Science and Nutrition, Kimchi Research Institute, Pusan National University, Busandaehak-ro 63 beon-gil, Geumjeong-gu, Busan 46241, Korea 2Department of Food Science and Nutrition, Tongmyong University, Busan 48520, Korea 3Department of Food Science and Biotechnology, Sungkyunkwan University, Suwon, Gyeonggi 16419, Korea 4College of Hotel & Tourism Management, Kyung Hee University, Seoul 02447, Korea BACKGROUND/OBJECTIVES: The purpose of this study was to examine whether plasma lipid profiles are affected differently by snack kinds with equal calorific values. SUBJECTS/METHODS: We compared a Korean traditional confectionery (dasik) with Western confectionery (cookie) in this regard. Controlled cross-over study consisted of two 3-week snack intake phases and for separating, a 2-week washout period (3-2-3) was carried out with 30 healthy women aged between 40-59 years old. Brown rice based Korean traditional confectionery and wheat flour based Western confectionery were used. The participants consumed either dasik or cookie every day for 3 weeks, providing 93 kcal a day. RESULTS: The total cholesterol (TC) in the dasik group had decreased significantly after 3 weeks (P < 0.05). Furthermore, in the dasik group, reduction in TC and low-density lipoprotein-cholesterol were greater than those in the cookie group (P < 0.05). CONCLUSIONS: Prioritizing functional snacks like dasik improves plasma lipid profiles; this may be useful information for individuals who cannot refrain from snacking. Nutrition Research and Practice 2016;10(6):590-596; doi:10.4162/nrp.2016.10.6.590; pISSN 1976-1457 eISSN 2005-6168 Keywords: Snack, cholesterol, plasma, cross-over trials INTRODUCTION4) would be more pronounced if some of the ingredients were replaced. Whole grains such as brown rice may diminish the The amount of time spent for snacking has increased in all chance of CVD [7], ischemic stroke [8], type II diabetes [9], and age groups in recent years, and calories from snacking comprise cancer [10]; for this reason, it is advisable to consume such almost a quarter of our daily energy intake [1]. Carbohydrate- staples often [11,12]. Recently, whole grain flours have become based desserts, in particular, those made from refined flour, more popular in the Western diet, even in America [13]. butter, eggs, and sugar are the most popular snacks among Medicinal plants used in Oriental medicine confer health children and adults [2,3]. benefits by ameliorating chronic diseases. In particular, red Dietary fat [4] and sucrose [5] contribute to elevate plasma ginseng is well known remedy in Oriental medicine, preventing lipid concentrations, which are a major risk factor for cardiova- serious diseases. Specifically, the effects of red ginseng in scular disease (CVD). Dasik (literally “tea food”) is a Korean humans include anti-hypertension, anti-diabetes [14], hypolipi- traditional confectionery. It is typically made by mixing steamed demic [15], and immune-stimulating activity [16]. In animal rice-cake flour, mung bean starch, and honey and shaping it studies, ginseng has been shown to improve vascular health using a special-purpose mold. No further baking or frying is [14], enhance energy metabolism [17], relieve pain, and prevent required to make dasik [6]. Sometimes, to confer some color cancer [18]. The active compound in red ginseng is ginsenoside, variety, pine pollen and roasted black sesame powder are used the health benefits of which are well established [18]. To reduce instead of rice-cake flour. Considering these ingredients and the energy content of food that derives from sugar and thus cooking process, dasik can be considered a healthier snack than minimize detrimental health effects, it is urgent that manufa- Western style desserts, which are made using flour, butter, eggs, cturers use sugar substitutes. Many possible candidates have and sugar, and which are baked or fried. Health benefit of dasik been introduced to the market, but extensive research is still This research was supported by Superiority and Functionality of Hansik (Korean Food) Research Program (#911040-1), iPET (Korea Institute of Planning and Evaluation for Technology in Food, Agriculture, Forestry and Fisheries), Ministry of Agriculture, Food and Rural Affairs. § Corresponding Author: Yeong Ok Song, Tel. 82-51-510-2847, Fax. 82-51-583-3648, Email. [email protected] Received: June 29, 2016, Revised: July 20, 2016, Accepted: August 10, 2016 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Sun Hee Hong et al. 591 ongoing to find a better natural substitute for sugar. Evaluation of the nutritional value of dasik and cookie In this cross-over study, we examined whether the choice of The nutritional values of dasik and cookie were analyzed. The snack with equal calorific values can affect plasma biochemical calorie, carbohydrate, lipid, protein, sugar, and sodium contents parameters differently, in particular, plasma lipid profiles and were determined on the basis of (1) the recipe (in the case diabetes-related indicators, if we had to take a snack. Speci- of dasik), or (2) the nutrition information (in the case of the fically, we compared Korean confectionery, dasik intake with cookie). A diet-analyzing program (CAN-pro 3.0; Korean Nutrition the consumption of Western confectionery, cookie in this Society, Seoul, Korea) was used. regard; the participants were middle-aged, healthy adults. Subjects SUBJECTS AND METHODS Thirty volunteers, healthy women aged 40-59 years old, were recruited from the general community through poster adver- Dasik preparation and control sample selection tising and e-mail campaigns. The aims of the study required Dasik was made using brown rice powder (CFEA Co., Cheolwon that blood be taken four times; this was explained in the Gun, Gangwon, Korea), fructooligosaccharide (FOS; CJ Cheiljedang advertisement, as were the possible number of participants, Co., Seoul, Korea), red ginseng extract (Korea Ginseng Co., duration of intervention, and exclusion criteria, which were: Daejeon, Korea), and propolis (Withealth Co., Geochang Gun, changes in body weight of more than 9 kg during the past Gyeongnam, Korea). This new recipe for dasik (brown rice- 6 months; use of hypertension drugs; diabetes; and renal, liver, ginseng dasik, Br/ginseng dasik) was developed previously by or CVD. In addition, subjects were not included if they were our collaborator based on sensory evaluation. Briefly, the brown participating in a weight-control program or taking supple- rice was roasted in the pan without oil. All ingredients (Table ments that might have affected serum lipid concentrations. 1) were mixed thoroughly to make dasik dough. The exact Patients with untreated hypertension (blood pressure > 140/90 amount of dasik dough was weighed and put into a special- mmHg) were also excluded. purpose mold. The dough was pressed hard enough to be shaped. Six pieces of Br/ginseng dasik were wrapped in cooking Samples size paper and kept in the refrigerator before being served. For The required number of subjects for the study was calculated traditional Western confectionery, cookie (Lotus Biscoff, Lembeke, using a G*Power program [19], wherein the effect size in a Belgium) was selected. The color and texture of cookie were two-tailed t-test was 0.5, significance level (α) was 0.05, and the closest to the Br/ginseng dasik. The calorie count of six pieces required power level (1-β) was 0.95. In two groups, 54 subjects of Br/ginseng dasik or three cookies is 93 kcal. The nutritional would be needed; baseline data were considered their own values of Br/ginseng dasik and cookie served to the subject control. Thus, we estimated that 60 subjects would be required, are presented in Table 2. assuming a 10% drop-out rate. However, because we used a cross-over study design, we recruited only 30 subjects, for a functional total of 60. Our primary outcome is plasma lipids Table 1. Recipe for traditional Korean confectionery, dasik, preparation and secondary outcome is diabetes related parameters Ingredients g/100g including blood glucose, insulin, and leptin levels Brown rice flour 65.4 Fructoligosaccharide 28.0 Cross-over study design Red ginseng extract1) 6.5 This randomized, controlled, cross-over study consisted of Propolis 0.05 two 3-week dessert-intake phases separated by a 2-week washout period (Fig. 1). Written consent was received from each 1) J product manufactured by Korea Ginseng Corporation (Daejeon, Korea) which contains Rg1+Rb1+Rg3 as an bioactive compounds at 5.5 mg/g concentration individual, and they were randomly assigned to one of two was used. groups (A & B), which were matched for age, weight, and Fig. 1. Cross-over study design used in this study. 592 Plasma Lipid Profiles affected by Snack Kinds baseline BMI. During the first period of study, Group A activity was expressed as metabolic equivalent (MET)- minutes consumed functional dasik (6 pieces, 93 kcal) daily as a dessert, per week, which was calculated by multiplying the activity whereas Group B had the cookies (3 pieces, 93 kcal). This constant by (1) the activity duration per day (min/day) and (2) accounted for approximately 5% of the individuals’ total calorie the number of times per week (days/week). The physical activity intake. After 3 weeks, the subjects in both groups discontinued constants used to calculate the MET values of walking, intake of their respective desserts and began the 2-week moderate activity, and vigorous exercise were 3.3, 4.0, and 8.0, washout period.